Basic Information
| Provider Information | |||||||||
| NPI: | 1669514055 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | JONES | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | FRANCIS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 HAVERHILL RD | ||||||||
| Address2: | STE 524 | ||||||||
| City: | AMESBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019132123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783887272 | ||||||||
| FaxNumber: | 9783887373 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 RESNIK RD | ||||||||
| Address2: | SUITE 104A | ||||||||
| City: | PLYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023604844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7815356053 | ||||||||
| FaxNumber: | 7815356056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 16092 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 0712167 | 05 | MA | MEDICAID | BLUE CROSS BS | 01 | MA | Y68647 | OTHER | AA11245 | 01 | HARVARD PILGRIM GROUP # | OTHER | 451847 | 01 | MA | TUFTS INDIV. PROVIDER NUM | OTHER |